Introduction: Metastases to the penis from urothelial carcinoma of the bladder are rare. In the literature about 300 cases of secondary penile malignancies were described; 35% out of these cases were from primary neoplasms of the bladder.
Material and methods: Two cases of penile metastasis from primary bladder urothelial carcinoma were described. The first case was 56-year-old patient diagnosed to have penile metastasis from microcystic urothelial carcinoma of urinary bladder. Before developing penile metastases, the patient underwent transurethral resection of the bladder tumor for two times and administration of intravesical Bacillus Calmette-Guérin (BCG). Later on the patient underwent radical cystectomy, penectomy, pelvic lymph node dissection and ureterocutaneoustomy. The second case was 56-year-old who were diagnosed to have left adrenal mass, multiple lymphadenopathy, bone metastatic lesion and penile mass. The excisional biopsy of penile mass was done and medical therapy, for bone metastatic lesion and radiotherapy for pain were started.
Results: The histologic report of the first case revealed microcystic urothelial carcinoma of urinary bladder. The pathological stage was pT4bN1M1. The patient died after 6 months of the operation. This case represent the first of microcystic variant of urothelial carcinoma which has metastasized to the penis. The histologic report of the second case showed metastatic urothelial carcinoma. The patients died within 5 months after beginning of the therapy.
Conclusion: Penile metastasis from bladder tumor is associated with high malignancy tumor and bad prognosis. Aggressive surgical approach is insufficient. Combination chemotherapy was reported to be beneficial